Association between patient-reported financial burden and catastrophic health expenditures in cancer survivors

Purpose

To measure rates of patient-reported financial burden, compare them across cancer types, and determine whether they are predictive of catastrophic health expenditures (CHE).

Methods

We extracted data from the Medical Expenditures Panel Survey from 2011 to 2017 to conduct a retrospective population-based cohort study and multivariable logistic regression to assess the financial burden of cancer across 16 cancer types and compare patient-reported metrics to CHE rates.

Results

Patients with ovarian cancer were most likely to report inability paying bills (34.5 %) and filing for bankruptcy (9.4 %), while patients with thyroid cancer were most likely to incur debt (22.4 %). Patients with kidney cancer had the highest mean debt ($46,915). CHEs were independently predicted by inability to pay medical bills (OR [95 % CI], 1.96 [1.14–3.35]) and bankruptcy filing (OR [95 % CI], 3.90 [1.21–12.60].

Conclusions and implications

We report important variations in the financial burden across cancer types and underscore the importance of assessing how patient-reported measures are related to CHEs. Policy implications. The financial burden of cancer care could explain the lack of improved outcomes with increased national health spending.